Examination of Edentulous patient

Summary

This script outlines a comprehensive dental examination process for removable denture patients, emphasizing the importance of medical and dental history, intra and extraoral examinations, and prosthetic assessment. It highlights the impact of tooth loss on residual ridge resorption, masticatory function, and facial support, with maxillary and mandibular bone loss patterns differing significantly. The video also addresses common pathologies like chronic candidiasis and fibrous hyperplasia in denture wearers. It concludes with the MM House classification for patient attitudes, crucial for treatment success.

Takeaways

• 🔍 Examination for removable patients involves a comprehensive medical and dental history, intraoral and extraoral examinations, and prosthetic assessment.
• 👁️‍🗨️ Extraoral examination includes assessing the temporomandibular joint (TMJ), neck, lips, and cheek areas, while intraoral examination focuses on the tongue, floor of the mouth, tonsillar region, and soft palate.
• 🦴 Bone loss after tooth loss leads to atrophy of supporting structures, with maxillary bone loss being vertical and palatal, and mandibular bone loss being vertical and oriented along the cross-sectional shape of the mandible.
• 📊 The rate of bone loss varies, with the mandible experiencing four times greater bone loss than the maxilla, averaging 0.1 millimeter per year.
• 🔎 Pathologies common in denture-wearing patients include chronic candidiasis and inflammatory fibrous hyperplasia, often due to ill-fitting dentures.
• 🦷 Prosthodontic assessment evaluates the current denture's retention, stability, vertical dimension, occlusion, centric relation, and aesthetics.
• 🤔 The stability of maxillary dentures is tested by applying unilateral forces to the posterior occlusal surface, while mandibular denture stability is checked by applying unilateral force to the anterior teeth.
• 🧐 Patient attitudes towards dentures are classified into four types: philosophical, exacting, hysterical, and indifferent, which can impact treatment outcomes and prognosis.
• 📝 It's crucial to understand a patient's MM House classification to tailor treatment expectations and approaches effectively.
• 🌟 The goal of complete denture treatment is to minimize functional, aesthetic, and psychological compromises resulting from tooth loss and its aftermath.

Q & A

What are the three main components of the examination for a removable patient?

The three main components of the examination for a removable patient include medical and dental history, intra and extraoral examination, and prosthetic assessment.

What should be examined during the extraoral examination for a removable patient?

During the extraoral examination, one should examine the TMJ, neck, lips, and cheek area.

What areas are typically assessed during the intraoral examination for a removable patient?

The intraoral examination should assess the mandibular lateral border, base of the tongue, floor of the mouth, tonsillar vision, soft palate, and oral mucosa.

What is the significance of observing the direction of bone loss in the maxilla and mandible?

Observing the direction of bone loss is significant as it helps understand the residual ridge resorption patterns, which differ between the maxilla (vertical and palatal direction) and the mandible (vertical and oriented along the cross-sectional shape of the mandible).

What is the average rate of bone loss in the maxilla and mandible after tooth loss?

The average rate of bone loss in the maxilla is 0.1 millimeter per year, with an initial loss greater in the first year. The mandibular bone loss is four times greater than the maxillary.

What are the consequences of tooth loss on a patient's oral health and function?

Tooth loss can result in residual ridge absorption, changes in intraoral structures, decreased masticatory function, loss of facial support and muscle toners, and psychosocial effects.

What are the common pathologies related to denture-wearing patients?

Common pathologies related to denture-wearing patients include chronic candidiasis and inflammatory fibrous hyperplasia, often caused by an ill-fitting denture.

What parameters should be evaluated during the prosthodontic assessment of a patient's current denture?

During the prosthodontic assessment, one should evaluate retention, stability, vertical dimension, occlusion, centric relation, and aesthetics of the denture.

How can you check the stability and retention of a maxillary complete denture?

The stability and retention of a maxillary complete denture can be checked by applying unilateral forces to the posterior occlusal surface and observing if there is any displacement.

What are the four types of denture patients according to the MM House classification?

The four types of denture patients according to the MM House classification are philosophical, exacting, hysterical, and indifferent.

Why is it important to understand a patient's MM House classification before starting treatment?

Understanding a patient's MM House classification is important as it helps in predicting the patient's behavior and cooperation during treatment, which can affect the prognosis and success of the removable service.